Left radial access, right room operation, peripheral intervention system

ABSTRACT

Systems and methods for left radial access, right room operation peripheral interventions are provided that include left radial bases to stabilize a left arm of a cardiac patient across a midsagittal plane, transradiant right radial bases to position a right arm of the patient, and radiodense radiation reduction barriers located between the patient and a doctor.

CROSS-REFERENCE TO RELATED APPLICATIONS

This utility patent application is a continuation of, and claimspriority to, U.S. patent application Ser. No. 14/780,714, filed in theUnited States Patent and Trademark Office on Sep. 28, 2015, which claimspriority to international patent application serial numberPCT/US14/34788 filed in the United States Patent and Trademark Office asthe Receiving Office on Apr. 21, 2014, which claims benefit of U.S.Provisional Patent Application Ser. No. 61/856,754, filed in the UnitedStates Patent and Trademark Office on Jul. 21, 2013, all of which areincorporated herein by reference in their entireties.

BACKGROUND

Trans-radial access (“TRA”) is an increasingly utilized procedure forperipheral interventions on catheter tables. Peripheral interventionsvia a patient's left wrist are advantageous from an anatomicalstandpoint. First, due to proximity and catheter support, sub-clavian,vertebral and certain carotid interventions are more easily performedvia a patient's arm rather than the groin. Second, renal and mesentericvessels have a superior oriented origin, and their access from the armis easier and more natural. Third, lower extremity interventions,particularly iliac and proximal superficial femoral artery, are moreaccessible from the arm when there is contralateral disease, or if theiliac bifurcation is hostile.

For the treatment of iliac disease, there are specific potentialadvantages for a radial puncture compared with the more traditionalfemoral approach. Femoral access may be difficult when crossing an iliaclesion from the contralateral side. Moreover, precise stent placementmay be problematic if contralateral iliac disease needs to be treated.In such cases, TRA may permit same-day discharge and prevent the need toaccess the contralateral groin and for crossover.

However, traditional TRA platforms do not permit both right and leftradial access from either the left or right side of the table.Specifically, existing platforms do not permit left radial access andoperation from the right side of the operating table. Additionally,existing arm boards that include radiolucent materials so as to notinterfere with medical imaging provide little to no protection fromionizing radiation to, e.g., a doctor performing left radial accessprocedures from the right side of the catheter table.

What is needed in the field of trans-radial access is a left radialaccess, right room operation system that is also suitable for use duringleft radial lower extremity procedures. The system should also reduce oreliminate staff exposure to ionizing radiation during catheterizationprocedures without impairing the ability to obtain the necessarydiagnostic medical images during the procedures. The system also shouldbe economical to manufacture, and it should be simple, effective, andreliable to use and reuse.

BRIEF SUMMARY OF THE DISCLOSURE

The present disclosure is directed in general to left radial access,right room operation, lower extremity peripheral platforms for use inleft radial peripheral interventions. More specifically, thetrans-radial access platform provides radiation reduction and allows forleft and right radial access, for different procedures, from lowerextremity peripheral to pacemaker and cardiac interventions. As will beunderstood from the present disclosure and by its practice, the variousembodiments described herein, and their equivalents are simple tomanufacture, install and use.

For example, in one embodiment according to the present disclosure, asystem is provided for use in supporting a patient lying in supineposition with left arm secured across the patient's midsagittal ormedian plane during a lower extremity peripheral procedure. The systemmay be a left radial access, right room operation, peripheralintervention system for use with an imaging system. The peripheralintervention system may have a left radial base that stabilizes a leftarm of a patient across a midsagittal plane of the patient during alower extremity peripheral intervention on a procedure table. A rightradial base may be positioned substantially parallel to an operatingsurface of the procedure table, the right radial base being transradiantand configured to position a right arm of the patient in a directionaway from the midsagittal plane during the lower extremity peripheralintervention. Also, a radiation reduction barrier may be placed apartfrom the left radial base and from the right radial base, the radiationreduction barrier having a radiodense material disposed between thepatient and an attending staff member to reduce scatter radiation fromthe patient in a direction of the staff member during a procedure.

In another embodiment, a left radial access, right room operationperipheral intervention system for use with an imaging system mayinclude a base board being configured for connection proximate a tablehaving a left side and a right side corresponding to a left arm and aright arm of a patient; a left radial base attached to the base boardand being configured to cushion and stabilize a left arm of a cardiacpatient across a midsagittal plane of the patient during a lowerextremity peripheral intervention on the table, wherein an attendingcardiologist may perform the intervention from the right side of thetable; and a radiation reduction barrier spaced apart from the leftradial base, the radiation reduction barrier having a radiodensematerial disposed between the patient and an attending staff member toreduce radiation scattering from the patient in a direction of the staffmember.

In yet another embodiment, a left radial access, right room operationperipheral intervention system for use with an imaging system may have abase board being configured for attachment proximate a procedure table;a left radial base attachable to the base board and being configured tostabilize a left arm of a patient across a midsagittal plane of thepatient during a lower extremity peripheral intervention on theprocedure table; a right radial base attachable to the base board anddisposed substantially parallel to an operating surface of the proceduretable, the right radial base being transradiant and configured toposition a right arm of the patient in a direction away from themidsagittal plane during the lower extremity peripheral intervention; aradiation reduction barrier attachable to the base board and spacedapart from the left radial base and from the right radial base, theradiation reduction barrier having a radiodense material disposedbetween the patient and an attending staff member to reduce radiationscattering from the patient in a direction of the staff member during animaging procedure; and a radiodense apron releasably connected to thebase board.

In a further embodiment, a left radial access, right room operationperipheral intervention system for use with an imaging system mayinclude a right radial base having a base board attachable to aprocedure table with a right side and a left side corresponding to aright arm and a left arm of a patient, the right radial base beingdisposed substantially parallel to an operating surface of the operatingtable, the right radial base board being disposed under the operatingsurface, the right radial base being transradiant and configured toposition the right arm of the patient in a direction away from themidsagittal plane during the lower extremity peripheral intervention; aleft radial base in connection with the right radial base board andbeing configured to stabilize a left arm of a patient across amidsagittal plane of the patient during a lower extremity peripheralintervention on the procedure table; a radiation reduction barrierattachable to a right radial base board under the table surface, theradiation reduction barrier spaced apart from the left radial base andfrom the right radial base, the radiation reduction barrier having aradiodense material disposed between the patient and an attending staffmember to reduce radiation scattering from the patient in a direction ofthe staff member during an imaging procedure; and a radiodense apronreleasably connected to the base board.

An exemplary method for left radial access and right room operationperipheral intervention system may include joining a left radial baseproximate a procedure table having a left side corresponding to a leftarm of a patient and a right side corresponding to right arm of apatient; stabilizing the left arm of a patient across a midsagittalplane of the patient with the left radial base; joining a radiationreduction barrier proximate the right side of the procedure table spacedapart from the left radial base, the radiation reduction barrier havinga radiodense material disposed between the patient and an attendingstaff member; and performing a lower extremity peripheral interventionon the procedure table through the left arm of the patient from theright side of the operating table.

Additional aspects of the present subject matter are set forth in, orwill be apparent to, those of ordinary skill in the art from thedetailed description herein. Also, it should be further appreciated thatmodifications and variations to the specifically illustrated, referredand discussed features and elements hereof may be practiced in variousembodiments and uses of the disclosure without departing from the spiritand scope of the subject matter. Variations may include, but are notlimited to, substitution of equivalent means, features, or steps forthose illustrated, referenced, or discussed, and the functional,operational, or positional reversal of various parts, features, steps,or the like. Those of ordinary skill in the art will better appreciatethe features and aspects of such variations upon review of the remainderof the specification.

BRIEF DESCRIPTION OF THE DRAWINGS

A full and enabling disclosure of the present subject matter, includingthe best mode thereof, directed to one of ordinary skill in the art, isset forth in the specification, which refers to the appended figures, inwhich:

FIG. 1 is a partial perspective view of an operating system according toan aspect of the disclosure;

FIG. 2 is a perspective view of the system as in FIG. 1, particularlyshowing an exemplary feature according to an aspect of the disclosure;

FIG. 3 is another perspective view of the system as in FIG. 1,particularly showing another exemplary feature according to an aspect ofthe disclosure;

FIG. 4 is an elevational view of an aspect of the system as in FIG. 1;

FIG. 5 is a plan view of another feature of the system as in FIG. 1, andFIGS. 5A-5D are respective end and side views of this aspect;

FIG. 6 is an elevational view of another aspect of the system as in FIG.1;

FIG. 7A is an elevational view of a further feature of the system as inFIG. 1 and FIG. 7B is an end view of the feature as in FIG. 7A;

FIG. 8 is an elevational end view of an operating system according toanother aspect of the disclosure;

FIG. 9 is an elevational view of a portion of a system according to anaspect of the disclosure;

FIG. 10 is a plan view of the system as in FIG. 9; and

FIG. 11 shows in parts 11A and 11B results of a radiation scatter surveyof an embodiment according to the disclosure.

DETAILED DESCRIPTION OF THE DISCLOSURE

Detailed reference will now be made to the drawings in which examplesembodying the present subject matter are shown. The detailed descriptionuses numerical and letter designations to refer to features of thedrawings.

The drawings and detailed description provide a full and writtendescription of the present subject matter, and of the manner and processof making and using various exemplary embodiments, so as to enable oneskilled in the pertinent art to make and use them, as well as the bestmode of carrying out the exemplary embodiments. However, the examplesset forth in the drawings and in the detailed description are providedby way of explanation only and are not meant as limitations of thedisclosure. The present subject matter thus includes any modificationsand variations of the following examples as come within the scope of theappended claims and their equivalents.

Turning now to FIG. 1, a trans-radial access catheter operating systemis designated in general by the number 10. The system 10 is structuredin general for left radial access, right room operation by permitting adoctor to remain on a right side of an operating table whilesimultaneously reducing radiation in inferior and superior regionsrelative to the operating table. The system 10 broadly includes a rightradial base or deck 12, a base board, main base or platform 14, asuperior radiation shield or barrier 16, which may include a unitary orinsertable radiation reducing material 48, a left radial base, wall orfence 18, an inferior right radiation apron or curtain 20, and aninferior left radiation apron or curtain 22 (see FIG. 2). The exemplarycomponents of the trans-radial access catheter operating system 10 maybe made from durable, water-resistant, reusable materials that aresusceptible to high pressure and/or heated sterilization and may also beconstructed to block or permit passage of radiation.

In the example of FIG. 1, a cardiac or lower peripheral patient 3 isplaced on a procedure or operating table 5 that hosts the main platform14. The deck 12, the radiation shield 16, and the left radial base 18may be in connection with the platform 14 or attached to the platform 14via mechanical connections that may include slots or holes 36 formed ina first or top side 32 of the platform 14. As shown, a right arm of thecardiac patient 3 may be laid along a first surface or first arm side 24opposite a second surface or connection or bottom side 26 of the rightradial base 12. Also shown, a first or interior face or side 54 of thefence 18 positions a left arm of the patient 3 across a midsagittalplane or center line 70 of the patient 3 (see FIG. 2). A board or brace(not shown) may be provided to stabilize and immobilize the arm forpreliminary access procedures and until the fence 18 is positioned. Aswill be explained in greater detail below, the fence 18 may be adjustedrelative to the platform 14 and to accommodate the patient 3. A handle62 may be provided to carry and position the left radial base 18.

As further shown in FIG. 1, one or more medical instruments 7 (shownschematically) are introduced through a sheath 9 in the stabilized leftarm. X-ray or fluoroscopic imaging systems or other types of medicalimaging systems are used by a doctor or staff on the right side of thetable 5, also referred to as the staff side or patient right arm side,to visualize on appropriate equipment or monitor 11 the positioning ofthe medical instruments 7 in the patient 3.

The exemplary deck 12 in FIG. 1 is made of transradiant orradiotransparent material such as high-density polyethylene (HDPE).Thus, the deck 12 is constructed to permit passage of X-ray photons 1during imaging of a patient, for example, to assess blockages in thepatient during a procedure. As shown, the first surface 24 of the deck12 is sufficiently large, as preferred by most doctors and staff, toaccommodate surgical instruments including wires, guides, balloons andstents 7, many of which may exceed 360 centimeters (cm) in length andrequire the space provided by the surface 24 in order to more easilyaccess and manipulate these instruments. Also, the X-ray or ionizingradiation 1 (shown schematically in FIG. 1) passes through the patient3, but the ionizing radiation material 48 of the radiation shield 16blocks or attenuates any rays 1 that are scattered by the patient's bodytoward staff working with the instruments 7 on the right arm side of thetable 5.

FIG. 2 most clearly shows the left radial base or fence 18 locatedopposite the vertically disposed radiation barrier 16. As shown, thefence 18 may be releasably attached to the base board 14 via theapertures 36, which are located in this example above a portion of theradiation curtain 22 with the operating table 5 located between the body14 and the curtain 22. As a 4-way arrow 72 indicates, the fence 18, likethe radiation barrier 16, may be adjusted toward or away from thepatient 3 to account for a smaller or larger patient 3 such that theleft arm remains in position across the midsagittal plane 70.

FIG. 3 particularly shows a portion of the trans-radial access operatingsystem 10 from the right side of the procedure room. As introduced, thesystem 10 may include the right radial base 12, the main platform 14,the radiation barrier 16, the left radial base 18, and the rightradiation apron 20. Here, the radiation barrier 16 may be hollow toallow for insertion of the radiation attenuating material 48. Thematerial 48 may be lead, antimony, tin, barium, bismuth, cesium,tungsten, or any suitable material to reduce scatter radiation. Theexemplary lead 48 may be about 1/16 of an inch or about 1.58 mm inthickness and sufficiently radiodense to absorb, inhibit, attenuate, orblock ionizing radiation emanating from a patient being x-rayed, i.e.,scatter radiation.

FIG. 3 further shows that the right radial base 12 and the curtain 20may be mated with the main platform 14. Alternatively, the right radialbase 12 may be unitarily formed with the main platform 14. Moreover, theradiation barrier 16 may include latches, hinges, spring elements or thelike 74 that permit folding of the barrier 16 down and over either theright radial base 12 or the platform 14 for patient positioning or forset-up and storage. Here, the barrier 16 may also include an angled areaor cut-out 76 to permit passage of a patient's arm to the base 12(compare, e.g., FIG. 1). An area 80 is established between the angle 76and the base 12 that is sufficiently large for the patient's arm but notso considerable as to reduce the effective radiation reduction area ofthe barrier 16. The surface area 80 also provides the physician with alarge, stable work surface. Also shown in this example, the base 12 isangled or has an angled area 78 to allow for a C-Arm of x-ray equipmentfor proper angulation. However, the deck 12 is not limited to theexemplary embodiment in FIG. 3 and may be constructed with a differentsurface area or geometries, including a lip at area 78 to securesurgical instruments on the deck 12.

With continued reference to FIG. 3 as well as FIG. 4, the rightradiation apron 20 may be attachable to the platform 14 via brackets orconnection devices 40. The curtain 20, similar to the radiation barrier16, may be made of radiation absorbing or reducing material 68 such aslead, antimony, tin, barium, bismuth, cesium, tungsten, and the like. Inthis example, the curtain 20 includes a series of pockets or sleeves 66into which respective material slabs or inserts 68 are placed. Thisarrangement may be preferred to a solitary lead (Pb) apron, forinstance, in order to reduce the weight of the curtain 20 when it isbeing attached to the deck 12 or the platform 14; to wash the curtain 20more easily; and/or to replace the inserts 68 with different or thickerradiodense materials as needed.

Turning now to FIG. 5 and its side and end views in FIGS. 5A-5D, thebase board 14 as briefly introduced is most clearly shown. As noted, theboard 14 may be unitarily constructed with the right radial base 12 butin this example, a series of slots or holes 36 in the first or top side32 extend through the second or bottom side 34 to permit componentplacements tailored to accommodate different sized patients. As shown,the board 14 may include a radiation reducing layer or insert 38 on orwithin the board 14 that sits under the operating table (not shown) butdoes not interfere with patient imaging. This insert 38 may bepositioned within and between radiation curtains (see, e.g., 120, 122 inFIG. 8). In one aspect, the insert 38 may be layered into the base board14. Also shown in FIG. 5, the board 14 may include curtain or apronbrackets or holders 44 that may have horizontally oriented apertures 44or vertically oriented apertures 46 for attaching the curtains 20, 22(see, e.g., FIGS. 1 and 2).

FIG. 6 most clearly shows the radiation barrier 16 as in FIG. 3. Asnoted above, the barrier 16 may be constructed entirely from radiationattenuating material 48, or the barrier 16 may be hollow for insertionof the material 48. A handle 52 may be provided for carrying the barrier16 and for manipulating its installation and removal from the base board14 or procedure table 5 as previously introduced. In this example, theradiation barrier 16 may include one or more connectors such as L-shapedtabs 58. These connectors 58 are inserted at an angle into the slots 36as shown in FIG. 1 and the barrier 16 is then pressed or snapped intoplace substantially perpendicular to the operating table 5. The handle52 may be used to quickly pull the barrier 16 up and out of the slots 36to adjust the barrier 16 or for cleaning and storage.

With reference to FIGS. 7A and 7B, the left radial base 18 of the system10 is shown most clearly. Here, the base 18 includes a first, staff, orpatient side 54 and a second or outer side 56. The handle 62, brieflyintroduced above, is for transporting and positioning the base 18. Asshown, the left radial base 18 may include one or more tabs or inserts58 for insertion through the holes 36 of the board 14 (see, e.g., FIG.5). In this example, the inserts 58 are L-shaped with a lower portionhaving a rectangular shaped extension. This construction permitsinsertion into the holes 36 at an angle and once in place, the base 18is pushed down and in contact with the board 14 to lock the base 18 inplace. Due to the pressure to be exerted by a patient's left arm againstthe base 18, a brace, block or step 64 may be included on either or bothsides 54, 56 to assist with stability. Also, on the patient side 54, anarm rest, cushion, pad or padded projection 60 is provided which facesin a direction of the patient. The arm rest 60 ensures that the leftarm, particularly the left wrist, crosses the midsagittal plane 70 (see,e.g., patient 3 in FIG. 2) and can also provide padding for the comfortand protection of the arm of the patient in a manner that promotesproper wrist supination to allow for safe and efficient access to thepatient's right artery.

In the embodiment shown in FIG. 8, a trans-radial access system isdesignated in general by the number 110. The system 110 is designed forleft radial access, right room operation as it permits a doctor toremain on a right side of a procedure table while simultaneouslyreducing scatter radiation to the doctor emanating from inferior andsuperior regions relative to the table, i.e., areas respectively aboveand below the table 5. The system 110 generally includes a right radialbase or platform 112 having an arm surface 124, a radiation shield orbarrier 116, which may include a unitary or insertable radiationreducing material 148, a left radial base, wall or fence 118 with an armcushion 160 and a stand 164, a right radiation apron or curtain 120, anda left radiation apron or curtain 122. The exemplary components of thetrans-radial access system 110 may be made from durable, reusablematerials that are susceptible to high pressure and/or heatedsterilization and may have radiation attenuation or blockingcharacteristics or alternatively, may permit passage of radiation.

As FIG. 8 shows, the radiation shield 116, the left radial base 118, andthe radiation aprons 120, 122 may be connected to the platform 112 viaconnecting devices or components 140, although other attachment meansmay be used in the alternative or in addition to mechanisms 140, such assnaps, snap-in ball joints, or the like. FIG. 8 also shows that theradiation shield 116 may substantially perpendicular to the platform 112and may have a tunnel or interior compartment 170 in which a radiationinsert 148 may be housed. The insert 148 may be extended away from thetable 5 to increase the height or width of the insert 148 as needed,such as by telescoping or unfolding sections of the insert 148. In thisexample, the insert 148 is a radiation absorbing material such as lead,cadmium, rhodium, or the like. In the case of an unusually largepatient, a portion of the insert 148 may be extracted from thecompartment 170 and pulled up and away from the table 5 to increase aheight of the radiation shield 116 to protect a doctor or staff fromradiation being scattered from a patient's body during x-ray or othermedical imaging.

Turning to FIG. 9, an inferior radiation shield or drape is designatedby the number 220. The drape 220 may be attached to a base or main board214 and may be divided into multiple sections such as sections 220A and220B. Here, the two sections 220A, 220B overlap one another at area 272.More particularly, the sections 220A, 220B each have loops or otherconnectors or attachments 274 that are in connection with bars, rods, orother connection devices 240A, 240B. The rod 240A may be inserted orconnected to a swivel assembly 276 that permits rotation of at least oneof the sections 220A, 220B from about 0 to 45 degrees relative to thebase board 214. For instance, the assembly 276 may include an upperportion or section 276A and a lower section 276B. The rod 240A may beinserted into the lower section 276B while the other bar 240B may bestationary or fixed and connected to upper portion 276A and to anotherconnection point or device 278. Also shown, a drive handle 280 may beprovided for a technologist to arrange the adjustable components of thesystem, such as by rotating section 276B relative to section 276A inorder to move drape 220A.

FIG. 9 further shows that the drape sections 220A, 220B may beconstructed with sections, sleeves or pockets 266 to receive insertablelead (Pb) boards 268 (shown in phantom) or other radiation attenuatingor blocking materials suitable to block radiation. More specifically,the insertable boards 268 may be radiodense, radiation absorbing orreducing material such as lead, antimony, tin, barium, bismuth, cesium,tungsten, and the like and may be from about 1/16 inch to about ¼ inchin thickness.

FIG. 10 most clearly shows the rod 240A in connection with the swivelassembly 276 to permit rotation of the rod 240A (and therefore curtainsection 220A shown in FIG. 9). As shown, the rod 240A may be adjusted,swiveled or rotated from about zero degrees to about 45 degrees asdepicted by angle 282 relative to the base board 214. Further shown, thebar 240B may be attached to or inserted into the assembly 276 as well asthe device 278. This adjustable arrangement may provide further scatterradiation protection to staff standing in a direction nearer the device278. The overlap provided at area 272 (see FIG. 9) will block scatterradiation with the rod 240A swiveled outward.

EXPERIMENTAL RESULTS Introduction

On Jun. 22, 2013, a testing service conducted a radiation scatter surveyin a heart catheterization room on a prototype based on the embodimentsof the present disclosure; i.e., a left radial access right room setupperipheral interventional platform designed to allow a physician toperform lower extremity peripheral, heart catheterizations and pacemakerprocedures while simultaneously reducing scatter radiation exposure tothe cardiologist and the procedure staff such as the technologist. Thepurpose of the survey was to determine the percentage and effectivenessof the prototype to reduce scatter radiation levels to the cardiologistand the procedure staff

Equipment and Set-Up.

The x-ray unit used for the survey was a GE Innova 2100. Cardio mode wasselected on the unit with indicated techniques of 60 kvp, 4 mA, 0.5 mmCu filtration, and a field of view (FOV) of 20 cm. Radiation scatterreadings were taken using a Victoreen and Inovision digital ion chamberin the exposure rate mode, using a five second exposure time. Toduplicate a patient, a phantom consisting of a square plastic containerwith 23 cm of water was used as the radiation scatter medium.

Measurements and Test Results.

The radiation measurements were made at the normal location [right sideof operating table] for the cardiologist and the technologist withtraditional radiation shielding in place and with the addition of theprototype. The radiation measurements were taken at each position at thefollowing strategic body locations: eyes, chest, waist, and knees.Radiation measurements were also taken at five different C-arm anglepositions typically used in heart catheterization procedures. As shownin detail in FIG. 11 (parts 11A and 11B), the test results indicated anoverall exposure rate reduction to the technologist by 50.8% and to thecardiologist by 64.4%. More specifically, radiation reduction to thecardiologist at eye level was 39%; at chest level: 71.7%; at waistlevel: 76.7%; and at knee level: 70.45%. In short, radiation reductionexposure to attending staff may be reduced by between about thirtypercent to about seventy-seven percent over a system that lacks theradiodense aspects described herein. Significantly reduced radiationexposure to procedure staff not only protects these professionals fromunnecessary scatter radiation, but such reductions increase theirprocedure room longevity based on parameters mandated by federal andstate radiation exposure limits.

While the present subject matter has been described in detail withrespect to specific embodiments thereof, it will be appreciated thatthose skilled in the art, upon attaining an understanding of theforegoing may readily produce alterations to, variations of, andequivalents to such embodiments. Accordingly, the scope of the presentdisclosure is by way of example rather than by way of limitation, andthe subject disclosure does not preclude inclusion of suchmodifications, variations and/or additions to the present subject matteras would be readily apparent to one of ordinary skill in the art.

That which is claimed is:
 1. A left radial access, right room operation peripheral intervention system for use with an imaging system, the peripheral intervention system comprising: a left radial fence being configured to stabilize a left arm of a patient across a midsagittal plane of the patient during a lower extremity peripheral intervention on a procedure table; a right radial deck disposed substantially parallel to an operating surface of the procedure table, the right radial deck being transradiant and configured to position a right arm of the patient in a direction away from the midsagittal plane during the lower extremity peripheral intervention; and a radiation reduction barrier disposed substantially perpendicular to the right radial deck and spaced apart from the left radial fence, the radiation reduction barrier having a radiodense material disposed between the patient and an attending staff member to reduce scatter radiation from the patient in a direction of the staff member during a procedure.
 2. The left radial access, right room operation peripheral intervention system as in claim 1, wherein the left radial fence includes a support surface for contacting the left arm.
 3. The left radial access, right room operation peripheral intervention system as in claim 2, further comprising a pad depending from the support surface.
 4. The left radial access, right room operation peripheral intervention system as in claim 1, further comprising a base board being configured to receive the right radial deck, the left radial fence and the radiation reduction barrier.
 5. The left radial access, right room operation peripheral intervention system as in claim 1, further comprising at least one radiodense apron in releasable connection proximate the operating table.
 6. The left radial access, right room operation peripheral intervention system as in claim 5, wherein the radiodense apron includes a plurality of pockets and respective radiodense inserts configured for insertion in the pockets.
 7. The left radial access, right room operation peripheral intervention system as in claim 5, wherein the radiodense apron and the radiation reduction barrier are disposed in a plane substantially parallel to each other.
 8. The left radial access, right room operation peripheral intervention system as in claim 7, wherein scatter radiation reduction exposure to an attending physician is reduced by at least sixty percent over a system without the radiodense apron and the radiation reduction barrier.
 9. The left radial access, right room operation peripheral intervention system as in claim 7, wherein scatter radiation reduction exposure to attending staff is reduced by between about thirty percent to about seventy-seven percent over a system omitting the radiodense apron and the radiation reduction barrier.
 10. A left radial access, right room operation peripheral intervention system for use with an imaging system, the peripheral intervention system comprising: a base board being configured for connection proximate a table having a left side and a right side corresponding to a left arm and a right arm of a patient; a left radial fence attached to the base board and being configured to cushion and stabilize a left arm of a cardiac patient across a midsagittal plane of the patient during a lower extremity peripheral intervention on the table, wherein an attending cardiologist may perform the intervention from the right side of the table; and a radiation reduction barrier arranged vertically and spaced apart from the left radial fence, the radiation reduction barrier having a radiodense material disposed between the patient and an attending staff member to reduce radiation scattering from the patient in a direction of the staff member.
 11. The left radial access, right room operation peripheral intervention system as in claim 10, further comprising a right radial deck disposed substantially parallel to an operating surface of the table, the right radial deck being transradiant and configured to position a right arm of the patient in a direction away from the midsagittal plane during the lower extremity peripheral intervention.
 12. The left radial access, right room operation peripheral intervention system as in claim 11, wherein the right radial deck is attached to the base board.
 13. The left radial access, right room operation peripheral intervention system as in claim 10, further comprising at least one radiodense apron releasably connected to the base board.
 14. A left radial access, right room operation peripheral intervention system for use with an imaging system, the peripheral intervention system comprising: a base board being configured for attachment proximate a procedure table; a left radial fence attachable to the base board and being configured to stabilize a left arm of a patient across a midsagittal plane of the patient during a lower extremity peripheral intervention on the procedure table; a right radial deck attachable to the base board and disposed substantially parallel to an operating surface of the procedure table, the right radial deck being transradiant and configured to position a right arm of the patient in a direction away from the midsagittal plane during the lower extremity peripheral intervention; a radiation reduction barrier attachable to the base board and spaced apart from the left radial fence and from the right radial deck, the radiation reduction barrier having a radiodense material disposed substantially vertically between the patient and an attending staff member to reduce radiation scattering from the patient in a direction of the staff member during an imaging procedure; and a radiodense apron releasably connected to the base board.
 15. The left radial access, right room operation peripheral intervention system as in claim 14, wherein the radiation reduction barrier includes radiation attenuating material being configured for extension.
 16. The left radial access, right room operation peripheral intervention system as in claim 14, wherein the radiodense apron includes a plurality of sleeves and respective radiodense material inserts.
 17. The left radial access, right room operation peripheral intervention system as in claim 14, further comprising at least two radiodense aprons.
 18. A left radial access, right room operation peripheral intervention system for use with an imaging system, the peripheral intervention system comprising: a right radial deck having a base board attachable to a procedure table with a right side and a left side corresponding to a right arm and a left arm of a patient, the right radial deck being disposed substantially parallel to an operating surface of the operating table, the right radial deck board being disposed under the operating surface, the right radial deck being transradiant and configured to position the right arm of the patient in a direction away from the midsagittal plane during the lower extremity peripheral intervention; a left radial fence in connection with the base board and being configured to stabilize a left arm of a patient across a midsagittal plane of the patient during a lower extremity peripheral intervention on the procedure table; a radiation reduction barrier attachable to the base board under the table surface, the radiation reduction barrier spaced apart from the left radial fence and from the right radial deck, the radiation reduction barrier having a radiodense material disposed between the patient and an attending staff member to reduce radiation scattering from the patient in a direction of the staff member during an imaging procedure; and a radiodense apron releasably connected to the base board.
 19. The left radial access, right room operation peripheral intervention system as in claim 18, wherein the radiodense apron includes at least two radiodense aprons, at least one apron movable relative to the other.
 20. A method for left radial access and right room operation peripheral intervention, the method comprising: joining a left radial fence proximate a procedure table having a left side corresponding to a left arm of a patient and a right side corresponding to a right arm of the patient, the left radial fence being configured to stabilize the left arm of the patient during a lower extremity peripheral intervention on the procedure table; stabilizing the left arm of the patient across the midsagittal plane of the patient with the left radial fence; joining a right radial deck substantially parallel to an operating surface of the procedure table, the right radial deck being transradiant and configured to position the right arm of the patient in a direction away from the midsagittal plane during the lower extremity peripheral intervention>## joining a radiation reduction barrier proximate the right side of the procedure table spaced apart from the left radial fence #and disposed substantially perpendicular to the right radial deck, the radiation reduction barrier having a radiodense material disposed substantially vertically between the patient and an attending staff member to reduce scatter radiation from the patient in a direction of the staff member during a procedure; and performing the lower extremity peripheral intervention on the procedure table through the left arm of the patient from the right side of the procedure table.
 21. The method as in claim 20, further comprising joining a base board proximate the procedure table and attaching at least one of the left radial fence and the radiation reduction barrier to the base board.
 22. The method as in claim 20, further comprising joining a radiation reduction curtain proximate the procedure table.
 23. The method as in claim 22, further comprising reducing radiation scattering from the patient in a direction of the staff member by at least sixty percent over a system lacking the radiation reduction barrier and the radiation reduction curtain. 